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CITY OF EVERETT PUBLIC WORKS DEPARTMENT W O#.—.� / gO <br />WORK GRDER APPLICATION <br />�ate 1r��tiated: j� Jc� —� 3 I Initiated by: �ti ,� ,B�^oo.Es I�' $g�S <br />Prrject Tir!e; _ CGS ['4d� �l� �kti fs P�4 � <br />Description oF ProjeQ' (Lccatior, who, what, when, why): <br />Cvun�y ,�L4f Scrve� 6� C��f� wa���^ 4he� J'e.v�� <br />ai s,,,s�z �w.,�y C�fs <br />Cross Refzrence: <br />❑ O�erating <br />Type of Project: � ���pital <br />Estimated �� <br />Projed Cost: _ __ <br />Chargeable to: ❑ Utilities <br />Manager's Approval <br />Signature: _ <br />Job Cost Nunber(s): <br />Verified JC � for Duplication ❑ <br />Comments: <br />Finanr.e hlanaaer's <br />Signa[ure: <br />..�.��..�.�_.�..:�f}U2•.K',��t1:URPP4_.. r�.]i„�i <br />❑ Grant <br />❑ Emergenc/ <br />❑ Engineering <br />❑ Statz <br />Funding: ❑ Federal <br />❑ Local <br />Estimated <br />Completion Date: <br />❑ Streets <br />FOR FINANCE USE ONLY <br />I <br />� JC Entered by: <br />❑ Other <br />Date: <br />Casswcrks Number(s): <br />Date: <br />�i Uate: <br />I <br />